A Review of: “The Prevention of Eating Problems and Eating Disorders: Theory,Research, and Practice”

Abstract

This study examines one possible source of social pressure regarding body shape and weight, and relationships with family, friends, and acquaintances, It compares the reported existence and influence of such pressure in a group of eating disorder patients and a community sample. Female subjects as a whole were significantly more likely than males to report that other persons influenced their body shape- and weight-related attitudes and behaviors, and it appears that females are much more likely than males to receive negative criticism of their bodies. It is suggested that research on the role of personal relationships in both the prevention and treatment of eating disorders may be worthwhile.     

Reflections on “Contact” and “The Gaze” in Clinical Practice

GoalsThis article explores the semiological value of contact and of the gaze in clinical practices. It questions the subjectivity involved in the caregiver/patient relationship and in nosography.MethodologyThe authors examine the place of the gaze based on writings of 19th century alienists. Then, they question the clinician's subjective experience – through the concepts of “sentiment” (Binswanger, Minkowski) and “praecox Gefühl” (Rümke) from the accounts of early stages of the clinical encounter.ResultsThe gaze plays a specific role in the early stages of the clinical encounter, especially in the landscape of schizophrenia. A draft classification of different types of gazes (off-center gaze, white gaze, ecstatic gaze, black gaze) is proposed, then nuanced.DiscussionAny attempt to classify the gaze leads to the deconstruction of any fixed typology. The gaze resists verbalization and even meaning, and in this, belongs to the dimension of anguish, an essential affect in a practice that does not seek to do away with relationship.ConclusionAt a time of increasing research in “eye movement abnormalities” in schizophrenia, it seems essential to renew our interest in the relational and therefore subjective – dimension as a specificity in clinical psychiatry. The gaze, then, would be this area without a place, this primary area of contact where relationship begins or not.     

Effects of Sex,Handedness, Stimulus and Visual Field on “Mental Rotation”

Shepard's mental rotation paradigm (e.g. Shepard and Metzler, 1971) was modified to allow tachistoscopic presentation of stimuli at varying angles of orientation (0° to 180°) in the right and left visual fields. Thirty male and thirty female subjects divided into three handedness groups (right-handers, non-familial and familial left-handers) judged whether a stimulus was a standard form or its mirror image. In general response times for correct judgements (RT_c) increased monotonically as a function of angle of orientation though the curves tended to be negatively accelerated rather than linear. Right-handers showed a slower rate of increase in RT_c as a function of angle than either left-handed group. Mean RT_c and the rate of increase in RT_c were equivalent for the two sexes and for the two visual fields. Both mean RT_cs and on the rate of increase in RT_c varied as a function of the stimulus.Error rates also increased monotonically as a function of angle of orientation. No sex or handedness differences in error rates were found. However, errors increased significantly less rapidly when stimuli were presented in the left visual field. It is argued that right hemisphere specialization for spatial processing minimizes the rate of increase in errors.The present failure to find sex differences may be of interest and it is argued that rapid presentation of stimuli results in subjects setting maximum and minimun response times. Within this relatively restricted “bandwith” of response times males and females may perform spatial tasks equally efficiently. Some confirmation for this hypothesis vs. an alternative based upon differences in hemispheric organization was found in a second experiment.     

Comment on “Neurofeedback Overtraining and the Vulnerable Patient”

Instead of looking at impediments to neurofeedback treatment successes as indicative of client vulnerabilities, understanding client sensitivity, hardiness, reactivity, and behavioral suppression, the therapist can better predict the course of treatment, provide an enhanced basis for continuous informed consent, and reframe self-perceived deficits as validation of patient talents. A self-report questionnaire is appended.     

The “consonance effect” and the hemispheres: A study on a split-brain patient

The present study investigated the consistency of the head-turning bias in kissing. In particular we addressed what happens if a person who prefers to kiss with the head turned to the right kisses a person who prefers to kiss with the head turned to the left. To this end, participants (N=57) were required to kiss a life-sized doll's head rotated in different orientations that were either compatible or incompatible with the participants’ head-turning preference. Additionally, participants handedness, footedness, and eye preference was assessed. Results showed that a higher percentage of participants preferred to kiss with their head turned to the right than to the left. In addition, the right-turners were more consistent in their kissing behaviour than left-turners. That is, with the doll's head rotated in an incompatible direction, right-turners were less likely to switch their head to their non-preferred side. Since no clear relationships between head-turning bias and the other lateral preferences (i.e., handedness, footedness, and eye preference) were discerned, the more consistent head-turning bias among right-turners could not be explained as deriving from a joint pattern of lateral preferences that is stronger among individuals with rightward as compared to individuals with leftward lateral preferences.     

The “Walk of Shame”: a Qualitative Study of the Influences of Negative Stereotyping of Problem Gambling on Gambling Attitudes and Behaviours

Problem gambling is known to be associated with significant stigma, but there is limited research on the negative stereotypes that underpin this judgement. Understanding the stereotypes that contribute to the stigmatisation of problem gambling may help to identify new approaches to reducing gambling stigma. Using data collected during 100 in-depth qualitative interviews with gamblers in Victoria, Australia, we explored factors which underpin negative stereotypes about people with gambling problems, the influence of negative stereotypes on behaviours and attitudes and differences in attitudes to different gambling products. Participants perceived that people with gambling problems were lacked responsibility and control, as were “lazy”, “stupid” and “greedy.” Electronic gambling machine (EGM) gamblers were particularly stigmatised. Negative stereotypes focusing on personal responsibility led to feelings of guilt and shame in people with gambling problems, as well as increased social isolation, and also impacted on moderate-risk gamblers, who contrasted their own behaviour with a stereotyped idea of a person with a gambling problem. Participants linked stereotyped portrayals of problem gambling to discussions of the gambling industry, which they perceived focused on control and responsibility, and the media, which they perceived emphasised extreme negative consequences from gambling. This study suggests that negative stereotypes focusing on personal responsibility for gambling problems are a factor leading to the stigmatisation of people with gambling problems.     

The Paradoxical Effects of the “Quota System”

Abstract

There is a lack of consensus about the pharmacological agent of choice to treat trichotillomania and which rating scales are best suited to measure the clinical severity and improvement of this condition. This overview summarizes the historical background, etiology, diagnostic criteria, epidemiology, course, prognosis, and various pharmacological treatments of trichotillomania. The case report describes a favorable clinical response of a 33-year-old female veteran with trichotillomania to the atypical antipsychotic quetiapine. It also provides data from the Massachusetts General Hospital (MGH) Hair Pulling Scale, a 7-item self-report scale that monitors symptom severity and treatment progress.     

The “Army” Incident: The Psychology of Uniforms and Their Abolition on an Adolescent Ward†

Abstract

The phenomenology of mystical experiences has been described throughout all the ages and in all religions. All mystical traditions identify some sense of union with the absolute as the ultimate spiritual goal. I assume that the pathway to both theistic and secular spirituality and our readiness to seek a solution in a psychological merger with something beyond the self evolves out of our human experience. Spirituality is one of man's strategies for dealing with the limitations of the life cycle, separation and loss, biological fragility, transience, and non—existence. Spirituality may serve as the affective component to a belief system or myth that is not rooted in scientific evidence but is lived as if it is true. Spirituality may take many forms, but I will suggest that in some instances it may serve as a reparative process in which one creates in the external world, through symbolic form, a nuance or facet of an internalized mental representation which has become lost or is no longer available to the self; or it may represent the continuity of the self-representation after death through a self—object merger. Lastly I will illustrate from the writings of two of our greatest poets, Dante Alighieri and William Wordsworth, how their poetry became interwoven with a profound spirituality. In Dante we will see the elaboration of a religious spirituality, while in the writings of Wordsworth a secular spirituality emerges interwoven with nature and belatedly his identification with “tragic man” as his mythos.     

Working With the ‘Difficult’ Patient: The Use of a Contextual Cognitive-Analytic Therapy Based Training in Improving Team Function in a Routine Psychiatry Service Setting

The clinical management of ‘difficult’ patients is a major challenge which exposes mental health teams to an increased risk of frustration and stress and may lead to professional burnout. The aim of the present study was to investigate whether a cognitive-analytic therapy (CAT) based training undertaken by a mental health team working with ‘difficult’ patients reduced professional burnout symptoms, improved patients’ service engagement and increased the levels of team-cohesion. Twelve mental health staff members from different professional and educational backgrounds took part in five 2-hour sessions providing a basic CAT training intervention, an integrative and relational model of psychotherapy for the treatment of borderline personality disorders. Participants were administered the Maslach Burnout Inventory (MBI), the Service Engagement Scale (SES) and the Group Environment Questionnaire (GEQ) before (T0) and after (T1) CAT training, and at 1-month follow-up (T2). A significant decrease were found, at T2, on the MBI Emotional Exhaustion scores, the SES Availability subscale, the GEQ Attraction to Group-Social and Group Integration-Social, while the MBI-Personal Accomplishment scores increased from baseline.The results of this study suggest that a CAT-based training can facilitate team cohesion and patient engagement with a service and reduce burnout levels among mental health team members dealing with ‘difficult’ patients.     

Good or Essential? The Effects of Victim Characteristics and Family Significance on Sentencing Judgments and Perceptions of Harm

Victim impact statements containing information about the character of the victim, as well as their significance to the family were varied across conditions to examine their effects on perceptions of harm and sentencing decisions for 166 death qualified participants. The results indicate that information concerning the victim's significance to their family significantly influenced sentencing judgments, whereas victim character information failed to do so. Perceptions of harm significantly mediated the relation between family significance and sentencing decisions. Implications for the Supreme Court ruling in Payne v. Tennessee (1991) and the relevance of including information about the victim as a means of communicating harm in capital trial sentencing are discussed.     

Effects of “Dual Focus” Mutual Aid on Self-Efficacy for Recovery and Quality of Life

Four million adults in the U.S. have co-occurring serious mental illness and a substance use disorder. Mutual aid can usefully complement treatment, but people with co-occurring disorders often encounter a lack of empathy and acceptance in traditional mutual aid groups. Double Trouble in Recovery (DTR) is a dual focus fellowship whose mission is to bring the benefits of mutual aid to persons with dual diagnoses. Three hundred and ten persons attending 24 DTR groups in New York City during 1998 were interviewed and followed-up for two years. A mediational model was specified and results across time were summarized with generalized estimating equations (GEE). Degree of DTR Affiliation (attendance and involvement) was significantly associated with Self-efficacy for Recovery and three quality of life measures: Leisure Time Activities, Feelings of Well-Being and Social Relationships. Self-efficacy fully mediated the effects of DTR Affiliation on Leisure Time and Feelings and partially mediated DTR’s effect on Social Relationships. The association of DTR involvement with self-efficacy is consistent with the processes inherent in mutual aid, although the observational nature of these data preclude causal inference. To improve outcomes, clinicians should facilitate affiliation with dual focus groups among persons with dual diagnoses as part of a comprehensive treatment approach.